Legacy Society Letter of Intent - Baton Rouge General Medical - brgeneral 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your Donor Name and Phone Number in the designated fields. Ensure that your contact information is accurate for future correspondence.
  3. Fill in your Address, City, State, and Zip Code. This information helps the foundation recognize you as a member of the community.
  4. Provide your Email Address for electronic communication regarding your legacy gift.
  5. Indicate your gift arrangement by checking the appropriate box. Options include Bequest, Charitable Gift Annuity, and others. If applicable, specify any additional details in the provided space.
  6. Select how you would like your gift designated. You can choose unrestricted or specify a service area such as the Burn Center or Cancer Center.
  7. If you wish to discuss details with a professional advisor, fill in their name and phone number.
  8. Decide on donor recognition preferences by checking either to be recognized publicly or to remain anonymous. Provide names if you choose public recognition.
  9. Finally, sign and date the form at the bottom to validate your intent and provide your Date of Birth if required.

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MyChart is EPICs patient portal.
0:47 2:05 Page. You have the option of using your email address as your username. Or entering a new one createMorePage. You have the option of using your email address as your username. Or entering a new one create a password for your account. And then confirm your identity by entering your birth. Date.
201 Baton Rouge General - Bluebonnet / Number of beds
Link BRG MyChart to Your Existing Account After activating your BRG MyChart account, log in. In the MyChart app, go to MenuLink My Accounts (or from the home screen, click add an organization.) On a desktop, go to the Link My Accounts activity. Search for Baton Rouge General. Click Link Account.
To receive a copy of your medical records, complete the Authorization for the Release of Records form found below. Email your completed form, along with a copy of your photo ID to MedicalRecords@brgeneral.org. We will contact you within one business day after your information is submitted.

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MyChart access is permitted only to authorized users who have been verified through an activation process. MyChart users have a unique username and password that is known only to them.

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